At the Region is an ongoing feature that discusses the state-by-state training, certification and employment requirements of first responder departments across the nation. In this issue, At the Region looks at requirements in FEMA Region V: Illinois, Indiana, Ohio, Michigan, Minnesota, and Wisconsin.

FEMA Region V - Emergency Medical Services (EMS)

Emergency Medical Technician certification levels result from a combination of national requirements and state-by-state regulations. All EMT training must meet minimum standards provided by the National Highway Traffic Safety Administration (NHTSA); this includes fundamentals in areas such as anatomy, medicine, and trauma, but states determine the final designations and requirements. An independent organization, the National Registry of Emergency Medical Technicians, also provides guidelines, and, although these are not mandatory, NREMT exams are used as the basis for certification at one or more levels in 45 states. Because of the variation in training, the NREMT national certification as an EMT does not equate to a license to practice, and transferring local certification depends on state-by-state reciprocity agreements.

Illinois

The Illinois Department of Emergency Medical Systems and Highway Safety (http://www.idph.state.il.us/ems/index.htm), under the Department of Public Health oversees the implementation of established standards for EMTs in the state. In order to be eligible to obtain a license, applicants must meet minimum requirements:

Unlike most other states, Illinois closely regulates EMT classes and does not rely on the NREMT paramedic certification but requires you to disclose whether you have ever taken the National Registry exam or not. Under Section 515.530(b) of the Emergency Medical Services and Trauma Center Code [77 Ill. Adm. Code 515.530(b)], Emergency Medical Technicians (EMT) candidates have the choice of taking either the State of Illinois examination or the National Registry of Emergency Medical Technicians (NREMT) examination. Illinois State requires that all EMT pass a state approved EMT training. EMT-Basic, EMT intermediate and Paramedic certifications are offered.

To be granted reciprocity in Illinois applicants must complete Part I of the EMT Reciprocity Application, attach photocopies of your EMT certificate or license and current American Heart Association Healthcare Provider Cardiopulmonary Resuscitation (CPR) card or equivalent. Applicants must also provide a letter from the EMS medical director indicating that you are in good standing and up-to-date with continuing education hours if you currently participate in an EMS system under an EMS medical director. If you cannot obtain a letter of recommendation, you will need to request a waiver. If you have not functioned as an EMT or under the direction of an EMS medical director, include a letter with your signature stating that you have never worked as an EMT or under an EMS medical director and request that the letter of recommendation be waived. Also, if you are requesting a waiver, you will need to provide photocopies of all continuing education you have completed during your current license/certification period. Other requirements include; complete Part III and Part IV of the application (required-application will not be processed if incomplete and/or requested documents are not provided).

The Indiana Department of Homeland Security http://www.in.gov/dhs/ oversees the implementation of established standards for EMTs in the state. Applicants for original certification as an emergency medical technician shall meet the following requirements:

• Be a minimum of eighteen (18) years of age.
• Successfully complete the Indiana basic emergency medical technician training course as approved by the commission and administered by a certified training institution.
• Pass the emergency medical technician written and practical skills examinations as set forth and approved by the commission.

The applicant must apply for certification on forms provided by the agency postmarked within one year of the date that the course was concluded as shown on the course report. You can find more on requirements here:http://www.in.gov/legislative/iac/T08360/A00040.PDF

The application includes name and address of the applicant, criminal history declarations of the applicant, the name of the training institution where training was completed, and other information required by the agency. All applicants for original certification shall provide evidence of compliance with the requirements for certification. Certification is valid for two years. To renew a certification, a certified EMTmust submit a report of continuing education every two years that meets or exceeds the minimum requirement to take and report forty hours of continuing education.

Reciprocity

To obtain certification based upon reciprocity, an individual must be a minimum of eighteen (18) years of age and meet one of the following requirements:

• Possess a valid certificate or license as an emergency medical technician from another state and successfully completes the written and practical skills certification examinations.
• While serving in the military of the United States; successfully completed a course of training and study equivalent to the material contained in the Indiana basic EMT training course and successfully completes the written and practical skills certification examinations prescribed by the commission.
• Hold a valid unlimited license to practice medicine in Indiana; and successfully completes the written and practical skills certification examinations prescribed by the commission.
• Successfully completed a course of training and study equivalent to the material contained in the Indiana basic EMT training course and successfully complete the written and practical skills certification examinations prescribed by the commission.
• Hold a current EMT registration from the National Registry and complete a course equivalent to the Indiana approved curriculum.

Any nonresident of Indiana who possesses a certificate or license as an EMT that is valid in another state, or a valid registration issued by the National Registry, upon affiliation with an Indiana certified provider organization may apply to the agency for temporary certification as an EMT. Upon receipt of a valid application and verification of valid status by the agency, the agency may issue temporary certification, which shall be valid for the duration of the applicant's current certificate or license or for a period not to exceed six months from the date that the reciprocity request is approved by the agency, whichever period of time is shorter.

Ohio

The Ohio Department of Public Safety, Division of Emergency Medical Services is responsible for the education, certification, and investigation of all emergency medical service and fire service providers in the state of Ohio. The state board of emergency medical, fire, and transportation services issues the appropriate certificate of accreditation or certificate of approval to an applicant who is of good reputation and meets the requirements of section 4765.16, which you can find here, http://codes.ohio.gov/orc/4765
Minimum requirements include:

• Be 18 years of age and not attending High School, except those students who are 17 years old, provided the student is enrolled in the 12th and final grade in a secondary program.
• Have not been convicted of, pled guilty to, or had a judicial finding of guilt for any of the following:
• Fraud or material deception in applying for, or obtaining, a certificate issued in accordance with code;
• A felony;
• A misdemeanor involving moral turpitude;
• A violation of any federal, state, county, or municipal narcotics law;
• Any act committed in another state that if committed in Ohio would constitute a violation.

To be granted reciprocity in Ohio applicants who completed training in another state must complete the reciprocity application (there is a $75.00 fee) and attach a copy of a current state certification and a valid National Registry card at the level for which certification is sought. The candidate must also forward the Verification Form to the state certifying agency of the state in which the initial training was completed, as well as any other state in which you hold or have ever held, certification. The applicant must mail all forms (application, state card, National Registry card, and a Declaration Regarding Material Assistance/Non-assistance to a Terrorist Organization Form) to 1970 West Broad Street Columbus, Ohio 182073.

If you are a candidate who served in the United States military and received your EMT training while in the military, you must complete the reciprocity application and attach a copy of a valid National Registry card at the level for which certification is sought. Applicants must provide proof of military service (DD 214, current military ID badge, statement of service), or proof of armed services training is required at the time the application is submitted. If you are a DoD candidate, a valid letter from the Director of Personnel, attesting that you have military affiliation must accompany the initial submission of the application. The candidate must also forward the Verification Form to the military site where training was conducted, so they can complete it. A copy of the course outline, including topic areas and hours of instruction in each topic area must be included with the form. The verification form, and course information, will be used to determine if additional course work is needed to meet Ohio minimum requirements. The candidate must mail all forms (application, National Registry card, proof of military status, completed Verification Form, course outline, and a DMA Form) to 1970 West Broad Street Columbus, Ohio 182073.

The Michigan Department of Community Health oversees the licensure and application of EMS personnel. An individual can file an application for licensure as a MFR, EMT, EMT-Specialist (AEMT), or Paramedic by:

• Completing a Michigan course within the last 2 years and be Nationally Registered;
• National Registry status if you are currently nationally registered and have not been licensed in another state, or you have completed a Military education course;
• Reciprocity/Endorsement if you are currently licensed in another state and are currently nationally registered or have been nationally registered in the past;
• EMT-Specialist only: apply to downgrade current license to either a EMT/MFR or upgrade to the new EMT-Specialist (AEMT) by completing the Michigan Bridge Course;
• Re-licensure if your license has expired within the last three years

Your application will not be complete until the State has received the proper verifications, i.e., course completion from your Michigan Education Program Sponsor, licensure from out of state licensing agency, military course completion from appropriate military branch, successfully passing the National Registry examination from the National Registry.

Once licensed by the State of Michigan, it is not necessary to retain the National Registry certification for license renewal or re-licensure. Michigan uses the National Registry for examination purposes only. Once you are licensed, all licensees are required to complete the continuing education mandated by the State. Being Nationally Registered does not exempt you from complying with the continuing education requirements for renewal of your Michigan license.

To be granted reciprocity in Michigan you must fill out the Reciprocity/Endorsement Application for Licensure. In accordance with Section 20961 of the Michigan Public Health Code, the Department may grant a license to a person who is licensed in another state at the time of application if the applicant provides satisfactory evidence as to all of the following:

• Provides evidence to the Department that the applicant meets Michigan licensure requirements;
• No pending disciplinary proceedings against the applicant;
• No license sanctions similar to those set forth in Sections 20165 or 20958 of the Michigan Public Health Code and currently in force against your license;
• The other State maintains licensure standards equivalent to or more stringent than those of this state

If your out of state education does not meet Michigan requirements as outlined on the Michigan Verification of Out-of-State Licensure Form (EMS-250), you are not eligible for licensure in Michigan unless you complete a Michigan approved initial education course.

The Minnesota Emergency Medical Services Board http://www.emsrb.state.mn.us/cert.asp
oversees the licensure and application of EMS personnel. To be eligible for certification by the EMS Regulatory Board as an EMT-Basic, EMT-Intermediate or EMT-Paramedic, an individual must:

• Successfully complete the U.S. Department of Transportation course, or its equivalent as approved by the Board, specific to the EMT-Basic, EMT-Intermediate or EMT-Paramedic classification; and
• Pass the written and practical examinations, approved by the Board and administered by the Board or its designee, specific to the EMT-Basic, EMT-Intermediate or EMT-Paramedic classification.

EMT-Basics, EMT-Intermediates, and EMT-Paramedics whose certificates have expired may renew them within four years of the expiration date. To renew a lapsed certificate, the individual must meet the renewal requirements and provide documentation to the EMSRB. Renewal requirements include:

• EMT-Basic - current CPR and 24-hour refresher course and practical skills exam through an EMSRB approved training program OR current CPR, 48 hours of continuing education (4 hours in each of the six modules of the EMT-Basic curriculum - remaining 24 hours in any/all of the modules), and practical skills exam at an EMSRB approved training program.
• EMT-Intermediate - current CPR and 48 hours of continuing education in the EMT-I curriculum.
• EMT-Paramedic - current ACLS and 48 hours of continuing education in the EMT-P curriculum.

Reciprocity

EMT-Basics, EMT-Intermediates, and EMT-Paramedics requesting reciprocity in Minnesota must hold current National Registry of EMTs certification. To request reciprocity, the individual must fax or mail a copy of the current National Registry of EMTs card to the EMSRB office and fill out an online disclosure form.

EMT-Basics entering Minnesota with current certification from another state, but without National Registry certification, must take a practical skills exam at an EMSRB approved training program and then successfully pass the National Registry of EMTs written exam. We highly recommend that a 24-hour refresher course be taken, as well. The certification from another state must be current throughout all testing to be eligible to take the National Registry written exam.

The Wisconsin Emergency Medical Services Unit, under the Department of Health Services, http://www.dhs.wisconsin.gov/ems/
oversees the licensure and application of EMS personnel. To be eligible for an initial license as an emergency medical technician, an individual must be:

• 18 years of age or older; be capable of performing the actions authorized in rules for an emergency medical technician — basic, an emergency medical technician — intermediate or an emergency medical technician — paramedic, for which licensure is sought; and, not have an arrest or conviction record.
• Have satisfactorily completed a course of instruction and training, including training for response to acts of terrorism, prescribed by the department or have presented evidence satisfactory to the department of sufficient education and training in the field of emergency care.

The department considers as satisfactory evidence of education and training in the field of emergency care any relevant education, training, instruction, or other experience that an applicant for an initial license obtained in connection with any military service, if:

• The applicant demonstrates to the satisfaction of the department that the education, training, instruction, or other experience obtained by the applicant is substantially equivalent to the course of instruction and training required.
• Have passed an examination approved by the department.
• Have such additional qualifications as may be required by the department.

Reciprocity

EMS personnel licensed or trained in another state may be eligible for licensure in Wisconsin. Wisconsin requires current National Registry certification for licensure for all license levels. Eligible applicants without current National Registry certification will need to pass the National Registry assessment examination. A letter of authorization for entry to the exam will be sent to you upon proof of eligibility. Electronic applications are submitted through the E-Licensing system. You will need to create an account in the E-Licensing system to apply for your Wisconsin EMS Certification/License. For more information, please go to the Wisconsin E Licensing page.